Brief Psychotic Disorder,

Transpersonal psychotherapy
and Empathic Resonance
A Personal Story
Jo Ryder
 • Self disclosure

• Symptomatology
• Transpersonal Therapy
• Erotic Transference & Empathic Resonance
 Brief Psychotic Disorder
• Part of the Schizophrenia Spectrum and Other Psychotic
Disorders
• These disorders include schizophrenia, other psychotic
disorders, and schizotypal (personality) disorder.
• They are defined by abnormalities in one or more of the
following five domains:
 Brief Psychotic Disorder
• delusions,
• hallucinations,
• disorganized thinking (speech),
• grossly disorganized or abnormal motor behavior
(including catatonia),
• negative symptoms.
 What is a Delusion?
• Delusions are fixed, blatantly false convictions deduced from
incorrect ideas about reality.
• They are maintained despite obvious, incontrovertible proof
to the contrary.
• They are not widely believed in the person’s culture or
subculture.
• A false belief that involves an extreme value judgment is a
delusion only when it defies credibility.
• Systematized delusions have a common theme or event and
make up a network of beliefs.
• Essential Psychopathology and Its Treatment, 2009
 Misdiagnosis
• Some diagnosed “delusions” have turned out to be true.
• It’s called the Martha Mitchell effect where a
psychiatrist, psychologist, or other mental health clinician
labels the patient's accurate perception of real events as
delusional and misdiagnoses accordingly.
• Martha Mitchell, was the wife of the attorney general,
who said illegal activities were occurring in the Nixon
White House. At the time it was thought she was mentally
ill. The Watergate scandal proved her claim true.
 DSM-5 definition of Delusions
• Delusions are fixed beliefs that are not amenable to
change in light of conflicting evidence. Their content
may include a variety of themes (e.g. persecutory,
referential, somatic, religious, grandiose).[…]

• (DSM 5 changed false belief to fixed belief, so delusions

need not be false….
• Beliefs are neither true nor false)
 DSM-5 definition of Delusions
• Excludes beliefs based on Culture & Religion
• According to the DSM, the majority is right!

• Or: this exemption avoids controversy…

• Presumably, it is not pathological to hold the same
beliefs as almost everyone where you live.
 DSM-5 definition of Delusions:
• Delusions are deemed bizarre if they are clearly implausible
and not understandable to same-culture peers and do not
derive from ordinary life experiences. […]

• An example of a bizarre delusion is the belief that an outside

force has removed his or her internal organs and replaced
them with someone else's organs without leaving any wounds
or scars…. (impossible)
• An example of a non-bizarre delusion is the belief that one is
under surveillance by the police, despite a lack of convincing
evidence…. (improbable)
 DSM-5 definition of Delusions:
• […] The distinction between a delusion and a strongly
held idea is sometimes difficult to make and depends in
part on the degree of conviction with which the belief is
held despite clear or reasonable contradictory evidence
regarding its veracity.
 My interpretation:
• Not a misinterpretation of reality (some “delusions”
may turn out to be true)
• We are all entitled to think something and get the
wrong end of the stick
• It’s the overinterpretation of a felt experience
• It’s the degree of conviction with which a person
attributes meaning, together with significant distress
that affects functioning
Yosimite Double Rainbow
 Delusions include:
• Persecutory delusions (i.e., belief that one is going to be
harmed, harassed, and so forth by an individual,
organization, or other group) are most common.

• Example: “The world is about to end.”

• Me: “what would you do if…”

 Delusions include:
• Referential delusions (i.e., belief that certain gestures,
comments, environmental cues, and so forth are
directed at oneself) are also common.

• Example: A woman believes a man in a TV commercial is

speaking to her specifically, telling her to buy a cleaning
product (she buys 1200 bottles).

• Me: passages from books, newspapers, song lyrics,

overheard conversations…
 Delusions include:
• Grandiose delusions (i.e., when an individual believes that he
or she has exceptional abilities, wealth, or fame)
• Erotomanic delusions (i.e., when an individual believes falsely
that another person is in love with him or her) are also seen.

• An example of erotomanic delusion: John Hinckley attempted

to kill President Ronald Reagan. He had the delusion that the
assassination would cause the actress Jodie Foster to fall in
love with him.
 Delusions include:
• Nihilistic delusions involve the conviction that a major
catastrophe will occur.
• Somatic delusions focus on preoccupations regarding
health and organ function.
 Delusions include:
• Delusions that express a loss of control over mind or
body are generally considered to be bizarre; these
include the belief that one's thoughts have been
"removed" by some outside force (thought withdrawal),
that alien thoughts have been put into one's mind
(thought insertion), or that one's body or actions are
being acted on or manipulated by some outside force
(delusions of control).
 Delusions include:
• Hallucinations (no, but Very Strong Creative Fantasy)
• Hallucinations are perception-like experiences that occur
without an external stimulus. They are vivid and clear,
with the full force and impact of normal perceptions,
and not under voluntary control. They may occur in any
sensory modality but auditory hallucinations are the
most common (usually experienced as voices, that are
perceived as distinct from the individual's own
thoughts).
 Delusions include:
• Disorganized Thinking (Speech) typically inferred from
the individual's speech.
• (Very active Inner Voice & echoing of speech)
• The individual may switch from one topic to another
(loose associations). Answers to questions may be off
topic.
• Rarely, speech may be so severely disorganized that it is
nearly incomprehensible and resembles "word salad“.
 Delusions include:
• Abnormal Motor Behaviour (including Catatonia)

• Problems may be noted in any form of goal-directed

behaviour, leading to difficulties in performing
activities of daily living.
• Catatonic behaviour ranges from resistance to
instructions (negativism); to maintaining a rigid,
inappropriate or bizarre posture; to a complete lack of
verbal and motor responses (mutism and stupor).
 Delusions include:
• Abnormal Motor Behaviour (including Catatonia)

• May manifest itself in a variety of ways, ranging from

childlike "silliness" to unpredictable agitation.
• It can also include purposeless and excessive motor
activity without obvious cause (catatonic excitement).
Other features are repeated stereotyped movements,
staring, grimacing, mutism, and the echoing of speech.
 Etiology
• Brief psychotic disorder lasts more than 1 day and remits
by 1 month.
• According to DSM-5, Psychotic disorders may be induced
by another condition.
• the psychotic symptoms can be a direct physiological
consequence of:
• Substance abuse
• medication
• another medical condition.
 What did the episode feel like?
• Surreal: Seeing repeated synchronicities and the inter-relatedness in
everything around me; experiencing a state of universal connectedness.
Giving my attention to something and seeing it happen in my life
experience.
• Awesome to start off with, it didn’t stop and went on to become a 24-7 LSD
trip over many weeks where you are in a state of altered perception, with
locked in, ongoing psychological distress (mentally and emotionally), with
continued physiological hyperarousal. Loss of touch with reality. Isolating.
• Several months of reduced cognitive ability, poor function, a period of panic
attacks and brain fog like depression.
 What it left me with:
• An experience of what it is to be in a state of
inescapable emotional distress: trauma
• subsequent re-occurrences
• Now for the fun part…. The processing of the whole
experience
 The set of causes for me
• What caused my psychotic episode?
• Psychotic disorders can be triggered by stress or
extreme personal crisis like the death of a family
member.
• They can also appear on their own.
 The set of causes for me
• Maybe it’s genetic? The cause may be related to certain
abnormalities in the chemical structure of the brain.
• In my family there is ASD, DCD, Aspergers, Dyslexia,
Parkinson’s. (A lot of non-neurotypical brains).
• ASD and Psychoses are on the same spectrum with a
common origin
• ASD is a risk factor for Schizophrenia
• Children with ASD more likely to have a family history of
psychotic disorders (this is how my eldest was
diagnosed)
 Processing of the Experience
• Personal Development Essays
• PCI: “The internet provides both risks and benefits for
people with mental health problems - Discuss ” - facing
my own mental health problem for the first time
• Foundation Course: “A Reflective Essay” - addressing my
mystic experience
• Diploma: “A Reflective Essay: Intentional use of the self
in psychosexual and relationship therapy” – working on
“unfinished business”
 Processing of the Experience
• Jerusalem Syndrome: weird psychological disorder that affects
tourists in the Holy City Mar 19, 2017 Goran Blazeski
• Type I refers to individuals already diagnosed as having a mental
health illness before visiting Israel
• Type II includes those people with a personality disorder but who
do not have a clear mental illness
• Type III includes people with no history of mental illness, but who
experienced a psychotic episode whilst in the city, with full recovery
afterwards…. Of the 42 individuals, 40 were from what doctors
described as “ultra-religious” Protestant families.
 Processing of the Experience
• Comparable Psychotic manifestations related to places.
• Stendhal Syndrome describes the breakdowns that art-lovers
sometimes suffer in Florence when confronted by the grandeur of
Renaissance frescoes.
• Japanese tourists in Paris sometimes have manic episodes, known
as Paris Syndrome when they realise a city they have idealized as
the most romantic place on earth contains all the rubbish, traffic
and overcrowding of any other major urban area. 
• Airport Syndrome, a condition found among tourists who get lost
and who experience psychotic episodes in airports.
 Processing the Experience
• I first came to the realisation that the cause of a psychotic episode
can emanate from a source that is both internal and physically
external to the self
• I was struck by the concept of a connection between the theme of a
person’s psychotic thoughts and a specific place, a physical location.
Why religiosity in Jerusalem and art in Florence? Why not religiosity
in Florence and art viewing in Jerusalem?
• The similarity to my own experience made me think: there was a
connection between visiting a site considered to be of great
significance and a theme to the mental phenomena occurring
afterwards.
 Processing the Experience
• My initial episode also included similarly religious themed psychotic
thoughts (and shamanic behaviours), occurring 24 hours after a visit
to the Hill of Uisneach, to attend the annual Bealtane Celtic Fire
Festival.
• The centre of Ireland in many ways, the enigmatic hill is one of the
most sacred and historic sanctuaries in the world. There are a
multitude of myths associated with this location.
• Extensive archaeological and geophysical surveys have
revealed a wealth of buried archaeological remains that shed light
on Uisneach’s history and its role as a ceremonial centre in
prehistory.
 Processing the Experience
• All of the shorter episodes I have experienced (with loss
of usual boundaries) since the initial one, gather
together similar factors:
• Precursors, stressors and triggers,
• Each replaying a small part of an initial scenario to re-
experience and re-live trauma in small fragments, whilst
at the same time creating new understanding each time
and further personal growth.
 Processing the Experience
• Each subsequent “episode” (an interaction where I fall ill/become
unwell) contains the same components & pattern each time:
• A trigger: an association formed with a new person I meet who I get
on very well with (very spiritual / good intuition)
• A precursor: There is vulnerability shown to me which I see, a
personal connection formed or disclosure and erotic transference
• Formed prior to a Stressor (for them): a strongly felt emotional
event occurring in their lives, like a death or a big fight with
someone else that has made them extremely upset.
• A close trigger and their stressor together make me feel unwell!
 Processing the Experience
• I have come to these understandings over time:
• The episodes come from a heightened ability to sense
the emotional state of other individuals and to feel it as
my own and more especially sexuality, distress and
emotional neediness.
• I am an empath
• Without awareness, it’s called psychosis and with
awareness, it’s a transpersonal experience
 Processing the Experience
• It has taken me several years of developing my sense of
self-awareness and several brief episodes to completely
understand that I am able to fully feel the emotional
material of others, even from a great distance away and
to distinguish between the emotions and energies of
others and those that belong mainly to me.
• To stay clear, you must know yourself well to tell the
difference with a projection of your own emotions and
issues.
 Transpersonal
• Transpersonal
• Transference
• Counter transference
• Projective Identification
 Transpersonal
“Experiences in which the sense of identity or self extends
beyond conventional, personal or individual levels”
• It includes spiritual self-development, peak experiences,
mystical experiences, trance, spiritual crisis, altered
states of consciousness, spiritual practices, expanded
experiences of living…
• It integrates the spiritual and transcendent aspects of
the human experience within the framework of
psychology / psychotherapy
 Transpersonal

• What does a peak or mystical

experience look like?
 Transpersonal
It is not It includes:
• Extra-personal • Inner voices
• New Age • Intuition
• The Right Brain (the child self, the
• Religion magical self, the role-
play self, the
autonomous self, the
surrendered self, the
intuitive self)
• Creativity
• Peak experiences
• Dreams
EXTRAPERSONAL TRANSPERSONAL
Spoon -bending Higher Self
Levitation Deep Self (Starhawk)
Extra-sensory perception Inner teacher
Dowsing (seeking water) Transpersonal Self
(psychosynthesis)
Working with crystals High Archetypes (Jung)
Clairvoyance The Soul (Hillman)
Telepathy The Superconscious
(psychosynthesis)
Radionics (electromagnetic radiation) Some peak experiences
Radiesthesia (divining) Intuition
Blindsight (cortically blind ability to Some healing
guess)
Fire-walking Some near-death experiences
Bloodless skin-piercing Upper Chakras
Out –of-body experiences Subtle energy systems
Paranormal generally Guidance self (Whitmont)
Fakirism (sufi muslim ascetic) The
Effie Soultani, Self
Psychosexual
Mind over matter Transfigured
Psychotherapist self (Heron)
 Transpersonal
• Practice in Transpersonal Psychotherapy:
• Visualization
• Guided fantasy
• (controlled symbolic visualization for psycho-
spiritual development)
• Dreams
• Meditation
 Transpersonal
• Practice in Transpersonal Psychotherapy:
Guided Visualization
 Transference
• In the therapeutic relationship:
• “the client’s experience of the therapist that is shaped
by his or her own psychological structures and past and
involves displacement onto the therapist, of feelings,
attitudes, and behaviours belonging rightfully in earlier
significant relationships.”
 Transference
• Erotic transference
• What does erotic transference feel like for an empath
• From men: I go into a light trance
• From women: I have an immediate strong urge to have
sex then and there
• If someone’s sexuality is invasive / unhealthy, I have a
very strong sexual boundary (unlike I do for crisis or
distress)
 Transference
• Projective Identification
• First discussed by Melanie Klein, this refers to the unconscious
projection of parts of the self into and not just onto another person.
• The recipient is pressured to identify with the disowned aspects
and behave in ways that conform to the ejected feelings and
representations.
• It moves beyond transference. Not only does the client experience
the therapist in a distorted way based on past relationships, they
exert pressure so that the therapist begins to experience
themselves in ways that fit the client’s unconscious fantasy.
• Examples
Empathic Resonance
 Empathic Resonance
• Empathy is the ability to understand and share the
feelings of another and be in-tune with or resonate with
others.
• An empath’s intense empathy creates a tuning fork
effect, wherein the empath seems to actually "feel" the
emotions of the people around them. 
• Many empaths are unaware of how this works. It can be
overwhelming.
 Empathic Resonance
• Empaths experience empathy towards a variety of beings or things,
including close associates, complete strangers, pets, plants and
even inanimate objects.
• Some are naturally more empathic towards animals (e.g., The Horse
Whisperer), to nature (earth empaths may be more prone to SAD),
to the planetary system, to mechanical devices, to buildings…
Others will have a combination of some or all of these.
• Empathy is not held by time or space. Thus, an empath can feel the
emotions of people and things at a distance.
 Empathic Resonance
• At times, it may be difficult to distinguish one's own
feelings from those of others.
• It can be emotionally or physically demanding on
someone who's empathic.
• There are also varying levels of strength in empaths. It
may be related to the individual's awareness of self or
their understanding of the powers of empathy.
• Empathy has both biological and spiritual aspects. 
 Empathic Resonance
• The science of empathy
• Empaths have an extremely reactive neurological
system. We don’t have the same filters that other
people have.
• Hyperresponsive mirror neurons
• Whilst research confirms that alcoholics may have a
genetic predisposition to addiction due to inherent
lower than normal dopamine D2 receptors, Judith Orloff
suggests empaths have increased Dopamine Sensitivity.
 Empathic Resonance
• Mirror-touch synesthesia: a rare neurological condition
which causes individuals to experience a similar
sensation in the same part of the body (such as touch)
that another person feels. For example, if someone with
this condition were to observe someone touching their
cheek, they would feel the same sensation on their own
cheek.
• People can actually feel the emotions and sensations of
others in their own bodies.
 Empathic Resonance
• Empath challenges:
• Becoming overstimulated
• Absorbing the stress and negativity of others
• Feeling things intensely
• Experiencing emotional and social hangovers
• Feeling isolated and lonely
• Experiencing emotional burnout
• Coping with increased sensitivity to light, smell, taste,
touch, temperature, and sound
 Empathic Resonance
• Thriving as an Empath: basic skills with regular use to
prevent overload
• Shielding
• Grounding & Earthing
• Daily self-care: eating well, minimizing stress, taking
quiet alone time, associating with positive people, being
in nature, immersing yourself in water to clear negative
energy, meditating, exercising and defining limits with
energy vampires.
 Empathic Resonance

• Empaths…

• Your intuition and your refined sensitivities are healing.

• Appreciate yourself, your openness

• and your ability to feel.